Patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) will benefit from rivaroxaban monotherapy both in terms of safety and efficacy. The AFIRE study included 2215 patients with atrial fibrillation and stable coronary artery disease (CAD). A subgroups analysis recently published in JACC Intv evaluated patients undergoing coronary stenting. The study compared rivaroxaban + antiplatelet...
This study was designed to determine the effect of carotid endarterectomy/angioplasty on early (baseline vs. 3 months) and late (baseline vs. >5 months) cognitive function in patients with asymptomatic lesions. This systematic research included 31 non-randomized studies. Regarding the immediate post-operative period, 24 of these papers reported significant improvement in cognitive function; one study reported significant deterioration;...
Paravalvular regurgitation after transcatheter aortic valve replacement (TAVR) have historically been associated with worse clinical outcomes. Even mild leaks have been shown to be harmful. This study looked at a real-world experience with the transcatheter heart valve SAPIEN 3 Ultra in the US. The SAPIEN 3 Ultra is a new generation balloon-expandable heart valve with...
In addition to aspirin, Ticagrelor offers better prognosis in patients that already had a stroke and have a high-risk cardiovascular profile. These benefits should be correctly balanced seeing as they are not free of risk. Antiplatelet therapy makes part of the standard treatment of cardiac or cerebrovascular patients. Ticagrelor has shown superior to clopidogrel in...
Aspirin monotherapy (ASA) reduced the combined risk of thrombotic and bleeding events compared against dual antiplatelet therapy (DAPT) in patients receiving transcatheter aortic valve replacement (TAVR). This meta-analysis has only reproduced smaller randomize study outcomes and does not include the OCEAN-TAVI registry, the only one that has shown something different so far. Even though ASA...
Patients with a bigger number of complex anatomical characteristics that increase PCI complexity have worse results at one-year followup. These data come from a large multicenter study (e-Ultimaster) recently published in EuroIntervention. The more complex the characteristics, the greater the increase in events. It is important to see past the obvious anatomical challenges (bifurcations, calcification,...
Aspirin discontinuation 1 to 3 months after angioplasty with continued P2Y12 inhibitor therapy reduces the bleeding risk without an increase in thrombotic events. This is also the case for patients admitted with acute coronary syndrome. Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor has been shown to reduce the risk of major events compared with...
01- Alternatives for Patients Allergic to Aspirin The new guidelines of chronic coronary syndromes make class IIb recommendations to use prasugrel or ticagrelor in aspirin-intolerant patients. This is not meant to replace dual antiaggregation therapy in aspirin intolerant patients, when needed; it is just a recommendation to use monotherapy with the most potent antiaggregant we...
Since November 2015, when the LEADERS FREE was published in NEJM, polymer-free drug coated stents had undoubtedly been the best treatment for patients at high risk of bleeding. The benefit was owed to the safety and efficacy of the polymer-free biolimus coated stent (also called umirolimus) vs. bare metal stents in the context of just...
Courtesy of the SBHCI. Monotherapy with a P2Y12 inhibitor after a minimum period (3 months) of dual antiplatelet antiaggregation (DAPT) is a valid treatment option to reduce bleeding in patients at high risk of bleeding complications. The present double-blind study presented at TCT 2019 simultaneously published in NEJM analyzed ticagrelor monotherapy (prior 3 months DAPT)...